MITC Registration Spring 2023

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Use this form to register for your 4 week online course. The information you enter is solely for the course tutor. Confirmation of your place and details of how to pay (for individuals) will be sent by email. If you have any questions email info@mindfulinthecity.co.uk

First name *

Last name *

Email address *

Mobile telephone number *

Please select from the following *

I am a member of the public

I am a student at QMUL (Queen Mary University)

I am a staff member at QMUL

Other:

Which course(s) do you wish to attend? *

Mindfulness Course (PUBLIC) starting Feb 28th 2023

Required

PLEASE READ: These courses are designed for people who want to find ways of working with stress more effectively. It gently encourages moving towards experiences (including difficulties) in order to be able to work with them more skilfully. This can be challenging as well as rewarding. If you have a current mental health issue such as severe depression or PTSD, or are in a period of major life challenge such as recent bereavement, active substance addiction or trauma, a Mindfulness course may not be right for you at this time. Please check the appropriate box *

I feel ready to participate in the course

I do NOT feel ready to participate in the course at this time

I would like to discuss this privately with the course tutor

Have you read the "Pre-Course Information Sheet" including the "Ground Rules" ? Read here: https://mindfulinthecity.co.uk/pre-course-info *

Yes, and I accept the "Ground Rules"

Please describe any physical illness or other limitation that may make sitting, standing or physical movement difficult for you:

Please describe any sensory impairment (e.g. sight or hearing) which you would like the tutor to be aware of:

Is there anything else (e.g. neurodiversity) you would like to make the tutor aware of?

Please indicate your level of experience: *

I have only read about mindfulness

I have practiced on my own with a book or app

I have attended a taster or short session

I have taken a course in the past (e.g Mindfulness First Steps)

I often use mindfulness techniques

Other:

Required

Data Protection and communication consent

The information you provide will be kept confidential and will NOT be shared with anyone other than the tutors. It will be deleted at the end of the course. By clicking SUBMIT you are consenting to receive communications from and about MITC and its courses. You can unsubscribe at any time by emailing unsubscribe@mindfulinthecity.co.uk

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